Cost-effectiveness of early intervention in psychosis in low- and middle-income countries: economic evaluation from São Paulo, Brazil

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dc.contributor.authorAceituno, D.
dc.contributor.authorRazzouk, D.
dc.contributor.authorJin, H.
dc.contributor.authorPennington, M.
dc.contributor.authorGadelha, A.
dc.contributor.authorBressan, R.
dc.contributor.authorNoto, C.
dc.contributor.authorCrossley, N.
dc.contributor.authorPrina, M.
dc.date.accessioned2025-01-20T17:06:59Z
dc.date.available2025-01-20T17:06:59Z
dc.date.issued2024
dc.description.abstractAims The effectiveness and cost-effectiveness of early intervention for psychosis (EIP) services are well established in high-income countries but not in low- and middle-income countries (LMICs). Despite the scarcity of local evidence, several EIP services have been implemented in LMICs. Local evaluations are warranted before adopting speciality models of care in LMICs. We aimed to estimate the cost-effectiveness of implementing EIP services in Brazil.Methods A model-based economic evaluation of EIP services was conducted from the Brazilian healthcare system perspective. A Markov model was developed using a cohort study conducted in Sao Paulo. Cost data were retrieved from local sources. The outcome of interest was the incremental cost-effectiveness ratio (ICER) measured as the incremental costs over the incremental quality-adjusted life-years (QALYs). Sensitivity analyses were performed to test the robustness of the results.Results The study included 357 participants (38% female), with a mean (SD) age of 26 (7.38) years. According to the model, implementing EIP services in Brazil would result in a mean incremental cost of 4,478 Brazilian reals (R$) and a mean incremental benefit of 0.29 QALYs. The resulting ICER of R$ 15,495 (US dollar [USD] 7,640 adjusted for purchase power parity [PPP]) per QALY can be considered cost-effective at a willingness-to-pay threshold of 1 Gross domestic product (GDP) per capita (R$ 18,254; USD 9,000 PPP adjusted). The model results were robust to sensitivity analyses.Conclusions This study supports the economic advantages of implementing EIP services in Brazil. Although cultural adaptations are required, these data suggest EIP services might be cost-effective even in less-resourced countries.
dc.description.funderNational Commission for Scientific and Technological Research (CONICYT)
dc.fuente.origenWOS
dc.identifier.doi10.1017/S2045796024000222
dc.identifier.eissn2045-7979
dc.identifier.issn2045-7960
dc.identifier.urihttps://doi.org/10.1017/S2045796024000222
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90826
dc.identifier.wosidWOS:001196947500001
dc.language.isoen
dc.revistaEpidemiology and psychiatric sciences
dc.rightsacceso restringido
dc.subjectBrazil
dc.subjectcost-effectiveness analysis
dc.subjectearly intervention
dc.subjecteconomic evaluation
dc.subjectlow- and middle-income countries
dc.subjectpsychosis
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCost-effectiveness of early intervention in psychosis in low- and middle-income countries: economic evaluation from São Paulo, Brazil
dc.typeartículo
dc.volumen33
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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